Dr. Christopher Constantino joins Peter Reitzes to discuss an important 2020 study on verbal contingencies in Lidcombe treatment and the related question, “What exactly is working in preschool stuttering treatment?”
Dr. Michelle Swift joins Peter Reitzes to discuss her study “Case file audit of Lidcombe program outcomes in a student-led stuttering clinic.” This research is the focus of much conversation right now in the stuttering community.
While the study reports that student clinicians “can achieve the same short-term treatment outcomes for children who stutter using the Lidcombe Program as those reported in the current published literature,” the study also reports that a small majority of families dropped out of treatment and that, on average, student clinicians needed more sessions per family to achieve positive outcomes. Dr. Swift is asked if other treatments should be used at times instead of Lidcombe or integrated with Lidcombe. Dr. Swift suggests that one possible reason for the high drop out rates is that families sometimes have to switch student clinicians during treatment. At the end of today’s episode Dr. Swift is asked to consider the possibility that such research may lead some to question wether students are qualified to treat preschoolers who stutter with Lidcombe.
Michelle Swift, PhD, is a lecturer and clinical educator in fluency disorders for the Flinders University Speech Pathology program in Adelaide, South Australia. Dr. Swift is co-author of the new and much discussed study, Case file audit of Lidcombe program outcomes in a student-led stuttering clinic. The study is published in the International Journal of Speech-Language Pathology.
One of the most challenging questions to satisfactorily answer in stuttering treatment and in the community is what causes stuttering? Today on StutterTalk we launch a series featuring a range of perspectives and experiences on this important topic. Our first guest for this series is Dr. Mark Onslow.
Dr. Onslow discusses his view that stuttering “appears to be a problem with neural processing of speech involving genetics” (link) and is asked to discuss brain imaging research on the cause of stuttering that is currently being conducted at the University of Sydney. Dr. Onslow is asked how his treatment and research experience may influence how he views causation and much more.
Mark Onslow is the Foundation Director of the Australian Stuttering Research Centre (ASRC) at The University of Sydney. From 2004-2008, Dr. Onslow was a Principal Research Fellow of the National Health and Medical Research Council of Australia, being the only speech pathologist to have received this distinction. Dr. Onslow’s accomplishments include authoring over 250 publications related to stuttering. Dr. Onslow is one of the lead developers of the Lidcombe Program, a widely used and researched preschool stuttering treatment (see full bio here).
Dr. Marie-Christine Franken and Caroline de Sonneville-Koedoot discuss their eagerly awaited, just published, rigorous scientific study Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial. A major finding reported in the study and on StutterTalk today is that treatment results for Lidcombe and RESTART-DCM treatment methods are very similar at 18 months post treatment onset. In response to a question formulated from this Stuttering Brain blog post, Dr. Franken shares on StutterTalk today that “At this moment I think it would be unscientific to claim that the Lidcombe Program is the best stuttering treatment.“
Franken, de Sonneville-Koedoot and their colleagues conducted a randomized controlled trial with an 18 month follow-up with 199 children who stutter between the ages of 3-6. All subjects had been stuttering for at least 6 months. 99 children received the Lidcombe Program treatment, a direct treatment. 100 children received the RESTART-DCM treatment, an indirect treatment. The researchers concluded that “results imply that at 18 months post treatment onset, both treatments are roughly equal in treating developmental stuttering in ways that surpass expectations of natural recovery.”
Dr. Marie-Christine Franken is a Specialist Fluency Therapist and the Speech-Language Research Lead at the Speech & Hearing Department of Erasmus University MC in Rotterdam, the Netherlands. Dr. Franken and her team of researchers published a much discussed 2005 pilot study which compared Lidcombe Treatment and DCM Treatment. Dr. Franken recently appeared on StutterTalk to answer listener questions about Preschool Stuttering and Its Treatment (Ep. 487).
Caroline de Sonneville-Koedoot is a PhD student at Erasmus University, in the Department of Health Policy and Management, the Netherlands, and a speech-language pathologist. Her current research focuses on the cost-effectiveness of therapy for children who stutter.
Charlotte Jolley in Perth, Australia joins Peter Reitzes to discuss being the mother of triplets who all received Lidcombe Stuttering Treatment. Sophia and Maddy recovered while Alex, now 8 years old, continues to stutter. Ms. Jolley reports that Alex received Lidcombe on-and-off for 3-4 years and participated in over 100 treatment sessions. Ms. Jolley expresses feeling that some of her previous speech-language pathologists gave up or “threw in the towel” on helping Alex. Ms. Jolley discussed feeling extremely pleased now that Alex is receiving treatment that focuses on acceptance, empowerment, meeting and learning from other children who stutter and easier ways of talking. After just a single session that focussed on acceptance, Alex is described as a “different boy.”
Ms. Jolley expressed great concern and dismay regarding Speech Pathology Australia’s proposal to the Australian Government Department of Treasury. Jane Fraser, President of the Stuttering Foundation, described the issue in a recent statement:
“Australia’s professional association for speech pathology has recently submitted a proposal to the Australian government seeking to provide reimbursement for only a single type of stuttering treatment, creating a ‘one-size-fits-all’ policy for treating pre-school children who stutter. We find this proposal unthinkable and strongly oppose any policy action to limit choices to a single method by controlling government reimbursements for healthcare practitioners in any field…”
Related Links:
Kathy Viljoen’s letter to Speech Pathology Australia – link
Janet Beilby’s letter to Speech Pathology Australia – link
Speech Pathology Australia’s proposal/budget submission to the Australian Government for 2015-2016 – link
The Stuttering Foundation’s Response/Statement titled Another Blunder from Down Under – link
Craig Coleman’s post/petition – A Dangerous Precedent from Australia: What It Means and What Happens Next – link
Speech Pathology Australia’s Response/Statement – link
Michael Palin Centre for Stammering Children letter to Speech Pathology Australia – link
Craig Coleman’s ASHA blog post, A Controversial Proposal on Stuttering Treatment from Speech Pathology of Australia: What It Means and What Happens Next – link
ASHA blog post by Ann Packman, Mark Onslow and Deborah Theodoros – link
International Fluency Association Press Release – link
Lidcombe the only effective treatment in Australia? – link
Submission to the Community Affairs References Committee of the Senate – “An inquiry into the prevalence of different types of speech, language and communication disorders and speech pathology services in Australia” – link
A very important question to Onslow and Packman – link
Deborah Theodoros has been misinformed about the efficacy of Lidcombe – link
The Australian Budget Lidcombe Proposal Debate: A Primer in Memes – link
Jane Fraser, Elaine Kelman, Craig Coleman, and Bob Quesal join Peter Reitzes to discuss a recent proposal by Speech Pathology Australia (SPA) which has many professionals and people who stutter concerned. In an ASHA blog post, Craig Coleman explains this serious issue:
“Recently, Speech Pathology Australia (the national speech-language pathology association of Australia) submitted a proposal to the Australian Government Department of Treasury that would require Medicare rebates be made available for children who stutter, but only if they are treated using the Lidcombe Program.”
Much is said on today’s episode. Jane Fraser begins by sharing her experience at the Stuttering Foundation hearing from families who do not always find success using Lidcombe Treatment. Jane stresses that a major concern about the SPA proposal is that “one size does not fit all” in stuttering treatment. Ms. Fraser is asked about the Stuttering Foundation’s statement on this issue and a recent Stuttering Foundation blog post. Next, Elaine Kelman is asked about the International Fluency Association’s press release which explains why they feel the Australian Proposal is not fully consistent with evidence based practice. Craig Coleman and Bob Quesal then join the conversation and discuss how there are better ways to advocate for people who stutter then by choosing only one treatment approach to reimburse. Mr. Coleman and Dr. Quesal share their concerns about the possible negative ramifications of the SPA proposal and much, much more.
StutterTalk invited Gail Mulcair, Executive Director of Speech Pathology Australia or another SPA representative on air to discuss these issues. SPA did not accept the invitation to participate.
Craig Coleman, MA, CCC-SLP, BCS-F is an assistant professor at Marshall University and a Board-Certified Specialist in fluency Disorders. Mr. Coleman is currently serving as coordinator of ASHA SIG 4 (Fluency) and as a member of the ASHA ad-hoc committee to revise the scope of practice in speech-language pathology. Craig is an adjunct instructor at Indiana University of Pennsylvania and Co-Director of the Stuttering U. summer program for children who stutter, their families, and SLPs.
Robert Quesal, Ph.D., CCC-SLP is a person who stutters, a professor emeritus of Communication Sciences and Disorders at Western Illinois University, a fellow of the American Speech-Language Hearing Association (ASHA) and a retired board certified specialist in fluency disorders.
Related Links:
Speech Pathology Australia’s proposal/budget submission to the Australian Government for 2015-2016 – link
The Stuttering Foundation’s Response/Statement titled Another Blunder from Down Under – link
Craig Coleman’s post/petition – A Dangerous Precedent from Australia: What It Means and What Happens Next – link
Speech Pathology Australia’s Response/Statement – link
Craig Coleman’s ASHA blog post, A Controversial Proposal on Stuttering Treatment from Speech Pathology of Australia: What It Means and What Happens Next – link
ASHA blog post by Ann Packman, Mark Onslow and Deborah Theodoros – link
International Fluency Association Press Release – link
StutterTalk® is a 501 (c)(3) non-profit organization dedicated to talking openly about stuttering. StutterTalk is the first and longest running podcast on stuttering. Since 2007 we have published more than 700 podcasts which are heard in 180 countries.
21 Dec 2020
What Exactly is Working in Preschool Stuttering Treatment? (Ep. 701)
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Dr. Christopher Constantino joins Peter Reitzes to discuss an important 2020 study on verbal contingencies in Lidcombe treatment and the related question, “What exactly is working in preschool stuttering treatment?”
Links: